Glusosamine is more that just glucosamine

March 2, 2006

Watch out. Read the declaration carefully, when you buy Glucosamine for your osteoarthrosis.

According to a new research study, Glucosamine did not help against osteoarthrosis of the knees. According to another study, glucosamine was so beneficially, that it ought to be standard treatment. Its important to know, that the Glucosamine in the two studies were not the same type.

If you are to believe the publicised GAIT-study, it is meaningless to take glucosamine for arthritis of the knees. It just doesn’t work.

The GAIT-study was both large and thorough. It encompassed 1,583 patients with arthritis and lasted for 24 months. The participants were on average 53 years old and 2/3 of them were women.

These many arthritis patients were organised into six groups by lottery. These groups receive the following treatment:

  1. 1,500 mg glucosamine daily
  2. 1,200 mg chondroitine sulphate (which is like glucosamine) daily
  3. A combination of the two first treatments
  4. 200 mg of the prescription medicine Celebra
  5. Placebo

No one knew what they received and all of the participants answered detailed questions about their pain, stiffness, walking distance, and so on before and after the 24 weeks. Each participant then received a score based on their answers which indicated the severity of their symptoms.

The goal of the study was to find out how many of the participants showed a 20% improvement after the 24 weeks, but the results were surprising. No fewer than 60% of those who received the placebo had a 20% or better improvement. The results were only slighty better in the other groups: 64% for the glucosamine group, 65% for the chondroitine sulphate group, 67% for the combination group, and 70% for the group taking the prescription medication. Only the last group differed from the placebo group enough to be statistically significant.

The combination treatment did work for a small group (354 of the participants) who related mild pain after the treatment as opposed to moderate-strong pain. 80% of these people were (at least 20%) better off.

But the glucosamine alone was not better than the placebo.

Protects the cartilage
Another study called the GUIDE study was presented in November at the yearly meeting of The American College of Rheumatology. It included 318 patients (88% women) who also had arthritis in their knees. They received daily supplements of:

  1. Placebo
  2. Glucosamine (1,500 mg per day)
  3. Paracetamol (1 gr. three times daily)

This study also lasted a half year, but this the groups which received paracetamol and glucosamine reported an improvement of 30% more than the placebo group, even though the study was structured the same way as the GAIT-study. There was also a tendency that the glucosamine was better than the pain relieving paracetamol.

Why was there such a large difference between GAIT and GUIDE? This can possibly be explained by an editorial in the New England Journal of Medicine, which originally published the GAIT-study.

The difference could be that glucosamine-hydrochloride was used in the GAIT study whereas GUIDE used glucosamine-sulfate. Sulfate is crucial for the effectiveness of glucosamine.

Two randomised studies have shown that glucosamine-sulfate puts the breaks on the development of arthritis in the knees. This could be proven using X-ray photographs.

Glucosamine sulphate counteracts the breakdown of cartilage!
The New England Journal of Medicine editorial comment on the GAIT study related the following: “Arthritis patients who wish to take dietary supplements… should… take glucosamine-sulfate, not glucosamine-hydrochloride.” The lead author of the GUIDE-study stated that, “1,500 mg glucosamine-sulfate once a day could become the preferred treatment for arthritis in the knees.” The studies ended differently, but their recommendations are the same!

So read the label carefully.
It should read: “500 mg Glucosamine-sulfate, corresponding to 400 mg Glucosamine.”

By: Vitality Council

References:
1. Clegg DO et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006 Feb 23;354(8):795-808.
2. American College of Rheumatology Annual Scientific Meeting in San Diego, California. Press release.

content.nejm.org